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tv   Discussion on Faith- Based Global Health Care Efforts  CSPAN  August 31, 2015 1:00pm-2:01pm EDT

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climate change poses the same threat right now. that's why one of the things i'll do while i'm in alaska is to convene other nations to combat this threat. since the united states and china work together to set ambitious climate targets last year, leading by example, one of the world's biggest emitters have come forward with new climate plans of their own and that's a good sign as we approach the global climate negotiations in paris. >> that was the president from his weekly address released on saturday ahead of this trip up to alaska over the next three days. got time for a few more calls as we ask our viewers what do you want to hear from the 2016 candidates on the issue of climate change. lois is waiting on the line for the democrats. good morning. >> good morning, thanks for taking my call. i think once again that it's grand old party of profits that looks at everything according to the bottom line. what's it going to cost me? whether it's air and global
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warming which is the result of that. we have to bite the bullet. yes, it will cost money to clean up the air and clean up the environment, but i think it's essential, and i am so tired of politicians on the right, unfortunately, that always, always, always look at profits. what's it cost? if they have a factory and it's throwing out dirt into the air it's cheaper than cleaning out that dirt. everything they do is about profit and i've really had it with that. thank you for letting me speak. >> we'll go to alice in pittsburgh, pennsylvania. the line for republicans, alice, good morning. >> good morning, john. i very much appreciate it and want to endorse every part of key west, florida's, comments. talking about earth and relating it to the iran deelz that's on the table. i have visited iran.
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those -- from ancient times the iranian people have been stewards of their earth. they have a very challenging chime at and -- and from ancient times until this very day it is a part of their -- their dna to take care of their resources, to guard them and to take care of their people. they are not out for the almighty dollar. they take care of themselves, their people and their climate. they developed the system of getting water from under the desert. i have seen -- they have wind farms that go forever. they have solar placements to use solar power.
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these are beautiful people. we should see them as a model for husbanding, for stewarding the earth not hating them. >> that's alice, pittsburgh, pennsylvania and our last caller in today's washington journal, make sure to join us tomorrow morning. we'll be right back here at 7:00 a.m. eastern and 4:00 a.m. pacific. have a great monday. ♪ ♪ >> and president obama announcing yesterday his administration is officially changing the name of alaska's mount mckinley to denali. the hill reports that by taking action to officially name the 20,000-foot peak the president is taking the side of alaskan natives. in a dispute that stretched on for more than a century. the mountain was also called mckinley for president william mckinley, fellow ohioan. house speaker john boehner released a statement that said there is a reason president mckinley's name has served atop
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the peak for more than 100 years and that's a testament to his great legacy. i am deeply disappointed in this decision. u.s. senator from alaska lisa murkowski had this to say. >> for generation, alaskans have known this majestic mountain as the great one. today we're honored to be able to officially recognize the mountain as denali. i would like to thank the president for working with us to achieve this significant change to show honor, respect and gratitude to the people of alaska. >> president obama is in alaska to attend a conference on the arctic and climate change. we talked about his visit this morning on "washington journal". >> what is the president's schedule today? where is he going to be appearing? >> well, this is one of the more pronounced pieces of his really strong career focused on climate change and that will certainly continue right up through today and today is the first part of this three-day swing and he's
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going to address a state department conference on the arctic with the name glacier. it stands for global leadership in the arctic and i don't remember the rest because the u.s. is the chair of something called the arctic council and it's a multinational initiative and we expect the president to focus very strongly on what are the front lines of climate change which is a change in arctic and this is a region where the melting ice is creating a lot of new interests in the u.s. and globally with russia and other arctic nations in the massive resources upon there and the near shipping opportunities and what the president is going to be focusing on are the environmental perils of the way the climate community is affecting that region including how to build resilience among communities that border the arctic and this is the area that the white house is pointing out again and again. they're losing over a football field a day as sea levels rise. >> that is the strong focus of his meeting today.
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>> in terms of reaction for folks on the ground, here is the headline for the national journal on energy. obama has no friends in alaska. environmentalists don't like permits for off-shore drilling and they want to see more. can you talk about the reception he's getting up there? >> yeah. it's interesting where the white house is positioned on this both from a policy standpoint and certainly from a political standpoint. the administration, as we've mentioned earlier has been very focused on climate change during the president's second term. that said, the administration does not want to close off, completely close off to oil and gas drilling because there is a huge hydrocarbon bounty there and one of the two big pieces of the arctic ocean off the northern coast and that's as much as 15 billion barrels of recoverable oil and natural gas reser
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reserves, as well. they've given royal dutch/shell the green light to do exploratory drilling this summer, but at every turn over the last few days they've been pointing something out which was that this was a lease that was granted to shell under the bush administration, not this administration and they've also been trying to point out again and again that they're really just allowing the very limited, small amount of drilling. here's a little bit of a scoop that we reported on friday. so this administration has never sold new drilling recently in the arctic and there is a plan on paper, the interior department plan which sells new offshore blocks off of the northern coast and companies next year and our reporting shows th shows that that is increasingly unlikely to happen. and yes to limited development that was essentially begun sort of in a conceptual sense under the bush administration, but they're not following his path on that. >> and look ahead to the last 17, 18 months of the president being in office here, what are
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the key milestones that he's hoping to hit on the issue of climate change before he ends his second term? well, one of them is essentially the protection of what's been his biggest climate initiative are these sweeping environmental protection rules to finally start to crack down on carbon pollution from the largest, unregulated source by far and that is the existed tweet of coal-fired power plant and that ruled the epa which the white house promoted heavily was finalized earlier this summer and now the big task is to protect it in the courts and to protect it politically because you have a lot of opposition among republicans on capitol hill starting first and foremost with the senate majority leader mitch mcconnel and he swore everything in his power and he's get being creative here and not only does he want to pursue legislation and he's reaching out to different states saying don't go along with this epa
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regulation and he's trying to get this in different ways and what the administration is hoping is the release of these regulations and the president's very strong political and rhetorical focus climate will bolster the negotiating position after the crucial climate change talks and global climate change talks in paris at the end of this year and that's where after years and years of incredibly rocky and at times on the verge of negotiations that have been on the verge of collapse countries are hoping to reach a final climate change accord of some sort and the goal of the obama administration is that the domestic actions pave the way for some kind of good international agreement. going back around to alaska this is an effort to show that he'll be the first sitting president to visit the arctic regions of alaska, and this trip is a combined focus on how climate change is affecting alaska and
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specifically what the impact is on native peoples in alaska and i think we'll see discussions on resilience and a look at how climate change is a threat to fisheries and tourism and lynchpins of the alaskan economy. >> it covers all these issues for the national journalism and environment correspondent there and always appreciate the good information. >> thanks for having me on. i enjoyed it. next, a look at the role of rem ijon and health and the importance of faith-based organizations that deliver care in countries with health challenges like aids and hiv. an official from the usaid center for faith-based initiatives with the role they play in responding to pandemics like the recent, bowla crisis in west africa. the center for strategic and international studies hosted the discussion.
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all right. good morning. sorry for the few minutes' delay. my name is tara. and it is my pleasure to welcoming you this morning to what promises to be an engaging publication on a new series of faith-based health care. before we get started, i want to thank shepherd and anita smith for all of their work on this morning's event. i also want to say thank you to julia peck and julian law who are instrumental in pulling everything together this morning. faith is a powerful force come community around the world. faith-based organizations are an important provider of health care globally and they're a resource for health services and support particularly at the community level and for hard to reach populations in some of the poorest places in the world.
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as rick warren settled, there may not be -- there usually is a church, mosque or other place of worship. engaging and leveraging the reach of faith leaders can be critical in the goals. the nexus between faith and health and the potential for better cooperation and new partnerships is an important topic for us here at csis. we've explored these issues through a variety of lenses including active collaboration around the aids 2012 conference in d.c. as well as through janet fleischmann's work looking for opportunities for faith leaders to play a role in promoting knowledge of an access to family planning and reproductive health services. these issues will continue to be a focus of our work. >> as we celebrate the role faith-based health care can play in the global health arena, we must also acknowledge the benefits associated with the
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role. the use of basic health services including family planning and immunizati immunization, as well as con tro rersys in places like uganda where discrimination against the lgbt community and people living with hiv. moving forward it will be important to engage productively on these sensitive issues. it is essential to better understand the role of contributions of faith-based providers and to improve faith-based communities and we'll hear more from all of these important topics from the panelists today. i will now turn the microphone over to bill summerskill, from the lancet who will introduce our first panel. >> thank you and good morning. on behalf of the authors, i'm delighted to introduce this session about the lance and faith-based health care. this was made possible by sponsorship by capital for good.
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in addition to the booklets you've received additional material is available online for free and the full contents will be published in the weekly edition of the lancet next month. faith-based organizations deliver a substantial amount of health care around the world, how much and to what benefit has not been well documented, in preparation for the sustainable development goals in which collaboration between different sectors will be crucial, this series sets out to estimate the contribution of faith-based organizations to health care for particular strengths and weaknesses of faith-based actors and how their expertise might be best recruited in the future. by doing so, the authors have initiated a respectful, science-based dialogue about faith-inspired behaviors to which we welcome the input of
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csis. the three panelists here were lead authors on one of the review papers in the series going from your left to right, jill olivier has worked with the world bank and is research coordinator at the university of cape town. she's also director of the international religious health assets program. jill combines these skills as the lead author of paper one, understanding roles of health-care roles in africa. andrew tompkins is emeritus professional at university college london. he combines the distinguished academic career with experience in the field with religious beliefs on behavior in the second paper controversies of
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faith and health the final review between faith groups for improved health was not intended as such, but rather plan as a brief viewpoint. however, peer reviewers were so enthusiastic that the authors were planned to extend the manuscript into a full-length review and leading that effort was gene duff, head of the partnership for faith and development and coordinator of the joint learning initiative on faith and local communities, and your far right, anita smith will moderate today's session. she is president of the children's aids fund and pasco-chair of the president's advisory council on hiv/aids. ladies and gentlemen, the panel. [ applause ]
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>> thank you so much to csis for hosting this important event and to bill for the introduction. i did want to ask bill one question before i start with the panelists. you would probably need to get back to the microphone, but this -- this entire series would not be possible without all of your support and i just wanted to hear from you as we start this discussion what your goals are in terms of how you want to see the material that's being push l published used and how you would like to see the outcomes through what you're supporting in this effort. >> thank you, anita. the founder of the lancet in 1823 set out with two purposes, to inform and to reform.
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so the name lancet means a surgical instrument and a narrow window and thomas said i want to use it for both these purposes to cut out bad practice and to shine light on good practice, and i think that still directs the way we approach topics and health is such a vast part of our lives with so many different interfaces that this is a really large area of health which has received disproportionate attention over the years. it's a very sensitive area, and i think that may have made it difficult for groups to explore it in the past, and i think it's also a very vast area with a hete heterogenous evidence based and
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it's difficult to make firm conclusions in the way one might do in other aspects of health care. so with this issue, what we want to do, however imperfect is to set down a marker and to say this is an important topic and it's going to actually be more important in the future and if we are to achieve the sustainable development goal, we need the help of all potential actors. what i'm hoping is that this initiates the dialogue which is then taken up by other science, sossology, health journals that we move the influence of faith-based provision of healthcare from the margins of the debate and make it mainstream. so my metric of success would be for people to write in three, four, five years' time and this is great, but it is so terribly out of date, this issue and i would like to see things move
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on, and as they do move on, i hope that the lancet can be part of that. >> great. thank you so much for that perspective which gives us a perfect foundation for presenters this morning. jill? >> thank you. good morning, everybody. i'm going to crane my neck a little bit because i do have a few slides and this paper i'm presenting on on behalf of my co-authors. for those youf not familiar with the area of the intersection of public health and development it's a diverse area with major evidence holes. i don't each say gaps. they are big, black holes where we simply don't know things like how many faith-based providers services there are. what this paper sought to do is to provide a synthesis based on a series of systematic reviews of which the authors were a part and the synthesis of primary search in which there are some
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substanti substantial evidence that could be committed. what the focus ended up being focused on is african faith-based health service providers. we were presenting this at the bank, but there were these kinds of quotes that have been floating around for the last 20 years and this idea that this is a substantial provision in africa by these faith-based health providers and the sense that we don't really know the numbers and we don't really know what's going on. these quotes have been around a long time and we do know a little bit more now in the recent time. so what this paper is focusing on is specifically on that cluster of countries in africa where there is a particular prism of faith-based biomedical health service providers and we're not looking at traditional healing practices here and we're not looking at faith healing and
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a variety of other important issues. this is really looking at the hospitals and the health care centers and in those regions and the evidence space is bias toward africa, christianity and english literature. i'm saying that now. we do not know about the islamic facilities and northern africa and the regions and there is some evidence in relation to those countries. >> this is a common slide and they self-declare the percentage of health service providers against the public service provider. so, for example, they normally accounted on number of hospital beds or a number of facilities and they would compare the faith-based normally the christian faith-based organizations over the government facilities. i would point out that these figures are highly contentious.
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i wouldn't like to be a quote saying i've quoted these. what the paper tries to impact is the fact that these sigures are very contentious and what i'll argue is there is a need to move away from this focus on the percentages of market share. the argument is that basing your entire engagement on the faith sector on the idea of whether or not they provide 20, 25, or 30% of the services, do they provide quality health care to the rural poor? do they emphasize universal health coverage to people that don't otherwise get access? do they provide a different kind of care that supports the system and makes the general national health system more resilient. really, the argument is to say moving away from those kinds of figures of market share and trying to look at things as utilization, and cost
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satisfaction and so we're putting on data in this paper and we were trying to pull on what data there is on these other aspects that we consider to be more important. >> i'll just touch on a couple of issues that we presented household survey data which is looking at utilization which did show some lower market share than we had originally assumed. however, it's comparing apples and oranges to the faith-based comparison so don't worry about that too much, but we did find quite a lot of evidence that the fact that a lot in those countries and a lot of patients were reporting on higher satisfaction levels and those high satisfaction levels were normally based on the idea that they were getting the higher quality of service in the faith-based business and this is the public facilities. there was also some evidence to show that health-based service commission was in weak health
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systems and that's not just in africa, but that's internationally and weak health systems is not just -- normally, weak health systems and also in times of humanitarian crisis and that is when healtfaith-based h services come in. i'm not going to go through the whole slide, but as i mentioned earlier, there is a push towards -- away from broad generalizations about faith-based health service providers and i would encourage you very strongly not to use the word fbo just generically. if are fbos and being specific in the evidence and being specific in the engagement and being specific in the implementation strategies is really important, and i'm going to stop there. >> thank you very much. so we will go ahead and have all of the presentations and then open for questions. so, andrew? >> we had a very interesting and
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challenging task of looking at the controversies, and as you would imagine from the title we had a rich diversity of people to inquire and include in the team and i think the key thing we wanted to emphasize in the paper was that there are many, many people who report faith in the world. in fact, the pew forum says in their surveys more than 84% of the world's population report having a faith. this slide shows some of the major faith and it involves looking at differences between faiths and sometimes differences within faiths. and that is a very important thing to do. the second slide i think just shows the importance of not being too simplistic in attributing anything to faith,
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belief alone. the slide just emphasizes that in the center we're talking about things like attitudes and beliefs and prejudices and behavior and choice of technologies and all of the things that we think of every day, but it isn't just faith that influences. sometimes it's just centuries and thousands of years of culture. sometimes it's social and economic aspects. sometimes it's issues in relation to the laws in the country which may actually conflict with faith. and obviously, there are very, very political dimensions and unfortunately, sometimes beliefs and behaviors are affected by extremist, ideological positions. >> when we looked at various
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components, we looked as you would see in the paper, at a series of health-damaging behaviors which included childhood marriage, opposition to immunization, violence against women and female genital mutilation. we looked at the way the faiths actually had a viewpoint on this. and then we looked at how not withstanding the considerable varieties there was often a commonality and we've got a lot of examples in the paper are ways in which groups and sometimes with different faith backgrounds have come to work together for the reduction of child marriage for the increase in uptick of immunization. for the improvement of care for women and for the reduction of stigma and improvement in the
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provision and care in hiv/aids. so these are some of the things that we looked at and this slide just shows a bit of a problem. what we found was that within the faith leadership group there was often a limited awareness of what was going on in the world. >> we actually found there was a considerable problem in faith leaders remaining within their intellectual faculties. at the same time we found that those working in some development agencies and some working on some developing agencies were actually, treatmently unaware of what faith actually meant and therefore there was a tendency particularly for those affected by intense, secular agendas to
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stay within their secular silos. so we had faith faculties and secular silence. this may be a bit of a parody, and i don't -- i do apologize to those of you who object to this, but we actually specifically raised it because we saw at the bottom some remarkable opportunities of faith groups and you're probably using the words that actually, i've just been told not to use, but faith groups working intensively with governments and local communities and we provide within the paper some great examples of that. what are recommendations? well, we would like to see that the health care leaders become more faith actives and the faith leaders become more health active. i'm not suggesting that all faith leaders join gyms or
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health leaders go to the mosque, but it's obviously important that literacy and understanding are improved. not withstanding these issue, we do provide some evidence and there's quite a lot of peer-reviewed evidence showing that there is remarkable opportunity for faith to be integrated within programs. and we can actually see that already there are opportunities for the imaginative program. so what do we seek to achieve from this paper? we would hope discussion, possibly disagreement, but we see actually quite likely to be an opportunity for groups to work together for the improvement of care and what our real goal is to move from controversies into compassionate, professional, patie
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patient-sensitive, faith-sensitive care especially for the hard to reach and we do not believe that the goals of sustainable development will be achieved unless some of the issues that we raised in our paper are taken into action. thank you. >> thank you. >> next one. >> there we go. >> good morning, everyone. thanks to csis and to shepard for helping organize this session and thank you, bill and the lancet and thank you my fellow authors and the working group of amazing people who collaborated over a sustained period of time to bring this unprecedented series on the path-based healthcare to launch at the conference on religion and sustainable development
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which is held over the last several days at the world bank. kay warren was a key inspiration to this series informed by her deep, lived-out personal experience of how religious and faith-based organizations transformed stigma and saved lives of people living with hiv/aids. our paper picks up where andrew just left off. it focuses on the question of partnership between public sector organizations, between governments and donors and faith groups in general and the question of what exists by way of partnership and what might scale up and strengthen partnerships. the paper lays out a case that the time is now right in the context of development trends and opportunities to very substantially increase engagement with faith-based organizations and it
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basically -- that they're moving beyond the question now of whether to engage, but how to collaborate. the paper offers a couple of signs including the recent meeting between president kim at the world bank and the holy father where they discussed their mutual approach to implementing a preferential option for the poor. at our conference over the last couple of days, a notion that was tagged in the paper of public sector organizations themselves becoming more activist around these issues was underscored by the activist participation of the government who have newly constituted a focus their agency on this work. on the next slide. >> next slide, please, anita. great. thank you. now the next slide. on the faith side, the paper reviews how existingu$ partnerships and mechanisms are
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expanding collaboration and we look at those in three groups. we look at large-scale interventions such as the australian government's extraordinary ten-year investment in papua new guinea where they worked through the congregational networks of seven denominations to provide services to the very poor there. we look at public co-funding for faith-based hospital and primary care through national networks such as the church's health associations throughout africa, and thirdly, we look at global health campaigns where they're involved and they mentioned no malaria campaign which today has raced over $66 million and is a significant donor to the global fund for aids, tb and malaria. an interesting partnership there between the faith body and the multilateral donor organization and the paper references the longstanding ongoing efforts of
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agencies to facilitate partnerships. i would like to just note in terms of the co-funding, the important leveraging by public sector of substantial private assets that the faith community brings to the work of development and to tag for your further reading a study of the revenues of u.s. faith-based ngos which in 2013 amounted to over $6 billion of which public funding represented only a small proportion. i think it was 77 -- 77 million, a small share. next slide, please. the paper reviews -- the paper drills down on this -- on the case for partnership by looking more specifically at contributions to the prevention of maternal and child deaths, and unpacks the every woman, every child framing by unicef
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that looks at the accelerated behavior, the key to determining health outcomes for women and children. and makes the point in a systematic way that faith communities are very well positioned to influence those key, health-related attitudes and behaviors such as breast-feeding, immunization, access to care that make a difference to those health outcomes. we offer a variety of interesting case studies from nigeria and mozambique and sierra leone and elsewhere and i command them to your more detailed attention. finally, the paper drills down on a series of recommendations for strengthening partnerships and those recommendations are clustered in five areas and again, time doesn't permit us to go into them, but we offer them for your further consideration. they include a suggestion of new business model, in a sense, ways in which both the development
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communities and the faith groups can reorganize themselves and strengthen themselves to be more effective in partnership mechanisms. it was interesting that when this paper was conceived almost 18 months ago the conference that took place over the last couple of days was not even intended, but it was absolutely fascinating for all of us to see how the work embodied in the lancet paper was very much a grounding for the conference over the last couple of days and the recommendations that you see here were elaborated extensively in the work of the conference which looked at ways to strengthen partnerships between public sector and faith-based organizations. thank you so much. >> thank you, jane. >> well, based on these presentations this is just a taste of what is in the document that you have that you will definitely want to read if you
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aren't already into it. thank you all for your excellent presentations. i just wanted to -- while you're preparing your questions in the audience, let me just ask each of you a question. jill, i wanted to clarify that the faith-based hospitals you were looking at, were you looking at clinics or just hospitals? how extensive was the data? >> the data was looking at all levels of health facilities down to the level. butta, gen, their data holds all over the place and most of those are ones that were christian health associations and they normally map the whole number of facilities down to private care level. >> there obviously is a lot of work to be still done than just beyond the christian facilities. is there work under way that you're aware of? >> there's work under way, but
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there's also, i want to stress there is complexity, as well. a lot of, for example, health facilities and faith-based facilities that are owned by the church, but operate as the public district hospital and they're not quite as clear cut and they're in a number of countries worldwide, too. and how many of those facilities would be in the partnership between government? >> it is per country and they call it as hospitals and there's probably 20 or so hospitals and they're normally in areas as not a part of the public system yet, so -- >> okay. great. thank you. >> andrew, one interesting paper and the look at the controversies and how do you and your team go about deciding what you were going to look at and how did the team work together
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to come up with the outcomes in the paper and with fear, trepidation, energy, enthusiasm and an objectivity, i'm just giving those off the top of my head and basically as scientists we are basically looking at what is the evidence, and we didn't have any particular axe to grind and as the readers of the paper will see there were representatives looking at all of the major faiths and issues. we came particularly from the perspective of what are the particular needs for hard to reach populations and particularly women and children in poor communities and poor countries. that was why we looked at some of the key risk factors for mortality rates and for poor nutrition rates and poor development of children and
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adults. how he did it, we basically looked at the problems and we analyzed them using traditional, sacred text and we also looked at the ways that his texts have been interpreted in different ways and then we moved on to see how the texts have actually inspired and driven health workers to provide services in very difficult situations. >> congratulations on already putting some legs in through the conference and i know it was a successful event, and i think one of the questions that people have is why have these partnerships been so difficult
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to bring about and why has it come to this place. the conference on religion and sustainable development effective partnerships to end extreme poverty which was held over the last couple of days at the world bank and co-hosted by the u.s. government by mark here in the front row and the british government and world vision and other leading faith-based organizations, and in itself i think it represents part of the answer to the question and an extraordinary collaboration among governments and faith-based organizations and the academic community around these issues and part of what i struggle with is a cultural divide. we are -- we have different -- we have different methods and different approaches. we definitely have a common
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ground and as framed now by the common goals and the commitment to end extreme poverty and we have clearly common ground, but we have different approaches and what is so heartening about the discussions over the last couple of days is it was the spirit of collaboration and the reciprocal frame. yes, the call for on the part of the public sector organizations for a very strong evidence grounding and really a challenge to the faith community to step up just the kinds of evidence that jill and her team, for example, have been presenting as a basis for discussion, but i think the work ahead continues to be the building of trust and the building of understanding and the building of faith literacy and development literacy across the two community, and i would like to just point out that the materials and all of the materials for the conference are available on the website of the joint learning initiative at
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www.jliflc.com. and i recommend those to you. >> great. thank you. now we'll open the floor to questions. there will be people coming by with microphones and so, please wait to get the microphone before we ask the question. i would like to identify yourself and your organization before you asked the question. we'll take three at a time and then we'll pose them to the panel, and we have several hands up here. >> good morning, ladies and gentlemen. thank you so much for your presentation. my name is rosemary segero. i am with an organization called hope for tomorrow based in kenya. thank you so much for your presentation. i just wanted to mention about what is it that has not been a
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partnership, a collaboration, outreach and the civil society, government and other people. so how do we make this happen and hiv fared because of lack of cooperation and the civil society and what we are talking here and i don't know what we are talking about so this message is very, very important to faith-based all over the world because without this message reaching them, they could be implemented. so how do we walk with you guys? we just came up with the applications for the communication for people in africa can hear what we are talking now, using health care, education and everything. so how can we collaborate instead of just hearing the report and what you are talking. thank you? >> thank you. >> my name is katie and i'm the health program coordinator on the corporate council of africa
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which is an association of businesses interested in africa. this question is mostly, i think, for andrew. did you find big differences between religions, particularly religions that do not have sacred texts or are not -- don't have one overarching philosophy for the entire religion like folk -- folk based religions? >> thank you. >> i'm retired member of the staff. i have worked in many countries in sub saharan africa, and for more than 35 years, and a lot of what is discussed in the sense that i expect your team to look
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at the relationship between faith based health services and government policy development and the relationship between funding agencies and faith-based institutions in countries and give examples to give a little clarity to my question. when i worked for the world bank and went on missions to countries my colleagues were very reluctant for us to spend time discussing with the baptists and the catholics and the presbyterian institutions. they were pretty unprepared to integrate statistical data from these facilities. i remember the case in the drc where at one time the catholics
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show that they're doing a lot more that the government is doing that this was integrated in the analysis for policy reforms or for program development or for program evaluation when i myself worked for the cameroon government before i joined the world bank, i helped and developed a relationship between the missionaries and the government especially in the area of medical statistics and the newest statistics we were collecting were from the sister, the nuns not from the government. i worked on other countries where when you visit a health center in an urban environment
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that is missionary run or faith-based run. attendance is probably four times the size of a more equipped, more more staffed pub health institution in the same town. there are several cities full of hospital in the country, it is not in the capital city. it is in some remote little town. mostly catholics or baptists. and so it's been there -- i hate to see us move ahead as if things have been very sweet and nice between government policymakers and develop
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institutions because it does not been the case. in fact, in some countries the missionaries that are trading health but the government got discouragement from supporting the programs because of world bank imf institutions discouraging the use of public funds in what was classified as private enterprise. >> thank you. >> and that has cost us a lot. >> okay. thank you for your observation. let's take one more question. and then we'll go to the panel. >> good morning. i'm john blevins, director of the inner faith at emery. my question is mainly to dr. tomkins but wonder if others have comments on it as well. in hard to reach and vulnerable populations particularly in activities and programs that might be of a contentious nature
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and cultural context, a lot of faith-based organizations that we're aware of that do that work, that work arises intrinsically around a complicated but potentially contentious negotiation between the faith-based providers that do that work and larger religious traditions. one of our concerns is that when actors from civil society or the multilateral or bilateral donors are made aware of the programs, how does it change the impact of the programs in ways that may be negative? that it makes them and the staff in those organizations more suspect or the work of those organizations suspect or maybe even puts those staff members and the people who receive services in danger? and i wonder if you saw any evidence of that and if you have any thoughts about ways that civil society organizations and the large donors can be aware of how to build respectful partnerships with those
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organizations reaching hard to reach and vulnerable communities. >> thank you. andrew, do you want to go ahead and respond? >> yeah. those were some great questions. thank you so much. if i could start with the core, which is coming out of the older questions about the collaboration, if we look at the political framework in which my comments are based, it is that sustainable goals are going to talk about universal health coverage. that's a big challenge. it's important. it's invites if we are to reduce poverty. the bank has changed its mind. it used to say you can only become healthy once you become rich. now they are saying, the bank is saying that you have to be healthy to increase your standard of living. several things. part of them, comments, have come out of review in the paper
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and my objectivity and partly comments because i have lived in africa for many years and have been privileged to do so. the first thing is that when the faith groups are involved in health care delivery, it seems to me that often there is a tokenism rather than a true involvement. and one of the challenges seems to be the coming out of this that the governments and the agencies actually need to lose the nervousness that you, sir, described. the anxiety. and just get real and say if we want to achieve health coverage, then we have to look at ways of working together with partners who are working in the poorest. now, that actually means that literacy, as jean was saying, needs to be developed. and there are some good examples in the paper on ways in which faith leaders have actually been the leadership of the programs.
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particularly in some of the health damaging practices and more recently our experience in northeastern nigeria is that faith leaders are absolutely vital in assisting the increase in development of immunization services which are tragically declined over the last few years. you mentioned about kenya. you gave a good example of countries where there are great opportunities for people in government and for donors and the people who work at delivering. to actually understand each other's language. and i think there needs to be a greater appreciation, knowledge, and respect. and at the moment i am quite blunt found that lacking in international development agencies. they do not want to accept that there are people who they disagree with in their own
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personal lives. so i think the challenge is how do we get people to move out of their personal prejudices and work into global care, which is what we're talking about. just sort of a short answer. >> either of you like to comment? >> i'm sorry. i didn't catch your name. mark, thank you. i think there's been a bit of a change since the era that you're talking about. i've been involved in this work for a long time, like a number of friends and colleagues have been as well. and in the beginning, even 15, 20 years ago, every time we started a meeting or every time we started writing something, the first sentence would have to be make an argument. it would have to make a statement about the relevance before thinking about the collaboration within the community. that's where market share figures were coming out of. that was our one piece of evidence people were using for that statement. but things have changed quite a bit. there is work. and published work on statistics on contracting.
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w.h.o. on the financial compensation relationship in three african countries. universal health care studies. i'm not saying they are not fault. and i'm not saying there is constant work to build between the providers. it is an ongoing, all partnerships. but i don't think it's quite the same as, no, we're not even going to think about it. i think there's been a change. they are lingering biases, secular biases many of you in d.c. will be familiar with and as authors we are very familiar with. i think that's what bill was saying this is an unusual area of engagement for "the lancet" because of those biases.
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there is a slight more openness to think about this, engaging. i think underlying your question was this, you know, why have the meeting in d.c. and talk about these things here rather than in the countries. i'm not sure if that was the underlying. all i can say is these partnerships are absolutely happening on the ground in countries. several partners here. john blevins. i know they are doing lots of work on collaboration and networking in kenya with local partners. and so i think it's not just here in d.c. that these conversations are happening. if that was the subtext to your comment. >> jean? >> just to support what my fellow authors are saying here and going to our sister from kenya's question around the challenges of partnership. what i'm excited about is there seems to be a real movement both on the policy side and faith side looking at developments and
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new approaches to forging those partnerships. i see deb derrick in the audience on friends of the global fought on hiv, aids, tb. organizations like the global fund are working intentionally on the challenge of how to engage more effectively and more inclusively local faith communities and faith-based partners in country. indeed, i was so heartened during our conference to hear christopher band from the global fund saying during the ebola situation in west africa they directed their grantees to repurpose funds for hiv, aids, to be to ebola. that was a wonderful example of the institutional flexibility obviously in a crisis but a a really, really good example of that. going to jill's point in terms of contracting and new
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innovative finance mechanisms and contracting, from your country they spoke at the conference yesterday and actually challenging faith-based health care delivery systems. to formalize and strengthen their mechanisms. in fact he kind of challenged them to say the mous you have are not worth the paper they're written on. and pushing people towards more contracting. on faith side i think it's up to us to step up to offer more robust collective organizations that bring us together in larger scale so we can deal as collective bodies not just small institutions with governments so they can achieve the scaleable objectives in terms of development. those are some thoughts. >> thank you. and andrew there was one more question for you between differences of

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